Myometrial invasion and hysterography in endometrial carcinoma

One hundred and seventy-nine patients with endometrial carcinoma underwent hysterography as part of their pretreatment evaluation. One hundred and twenty-six women received preoperative irradiation followed by hysterectomy; 30 had surgery alone; while 23 received radical radiotherapy. We have classified hysterograms by the degree of tumor invasion suggested radiographically and have compared these, in the operated cases, with postoperative pathologic examination. Characteristically, lesions confined to the endometrium, or with superficial myometrial penetration, demonstrate either no radiologic abnormality or a small, shallow defect by hysterogram. In those patients with deep myometrial invasion of cancer, hysterograms usually demonstrate a large defect in the endometrial cavity. We believe that hysterography helps assure optimum treatment of each individualized case by helping to determine the volume of tumor and extension into the myometirum.